Use of intraosseous hypertonic saline in critically ill patients

J Vasc Access. 2019 Jul;20(4):427-432. doi: 10.1177/1129729818805958. Epub 2018 Oct 17.

Abstract

Background: Rapid administration of hypertonic saline 23.4% is crucial in treatment of herniation syndromes. Hypertonic 23.4% saline must be administered via a central line. In cases where central line access is difficult to obtain and leads to delay in therapy, placement of intraosseous access can be lifesaving.

Main body: The purpose of this case series is to describe the use of intraosseous administration of 23.4% saline in critically ill patients and to assess feasibility.

Conclusion: Intraosseous administration of 23.4% saline in 6 adult patients with neurological emergencies was feasible and should be considered in cases where obtaining intravenous access is time consuming.

Keywords: Intraosseous; critical care; extravasation; hypertonic saline; neurologic emergency; osmotic therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged, 80 and over
  • Catheters
  • Critical Care / methods*
  • Critical Illness
  • Emergencies
  • Encephalocele / diagnosis
  • Encephalocele / etiology
  • Encephalocele / physiopathology
  • Encephalocele / therapy*
  • Feasibility Studies
  • Female
  • Fluid Therapy / instrumentation
  • Fluid Therapy / methods*
  • Humans
  • Infusions, Intraosseous
  • Intracranial Hypertension / complications
  • Intracranial Hypertension / diagnosis
  • Intracranial Hypertension / physiopathology
  • Intracranial Hypertension / therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Saline Solution, Hypertonic / administration & dosage*
  • Treatment Outcome

Substances

  • Saline Solution, Hypertonic